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General NPI Number Information
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NPI Number | 1528067865
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Entity Type | Organization
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Legal Business Name | FREEBURG CARE CENTER INC
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Dates
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Enumeration Date | 07/19/2005
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 746 URBANNA DR
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City | FREEBURG
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State | IL
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Zip | 62243-1904
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Country | US
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Telephone | 618-539-5856
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Fax | 618-539-3412
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Provider Business Mailing Address
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Address Line | 746 URBANNA DR
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City | FREEBURG
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State | IL
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Zip | 62243-1904
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Country | US
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Telephone | 618-539-5856
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Fax | 618-539-3412
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Authorized Official
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Title or Position | CONTROLLER
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Name | MR. ROGER W BAGLEY
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Credential |
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Telephone | 618-549-8331
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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